1998 Volume 41 Issue 5 Pages 387-392
TheStreptococcus millerigroup is found as resident flora in the oropharynx, gastrointestinal tract, and genitourinary tract. It is recognized as pathogenic in man, with an ability to form abscesses.There have been a few reports documenting the importance of S. milleriin the development of empyema in Japan. We report a case of lung abscess and empyema caused by oral streptococci. A 69-year-old female was diagnosed with NIDDM at the age of 53 years, but glycemic control had been poor. The Patient was admitted on June 11, 1997 because of a high grade fever and left anterior chest pain. A chest X-ray showed a niveau in the lower lobe of the left lung, and a diagnosis of lung abscess was made. Antibiotics were ineffective, and leftsided empyema and atelectasis developed. Continuous transthoracic cavity drainage was instituted four days later, and bacteria of the S. millerigroup were detected in the drainage fluid. On the 19 th hospital day, the empyema improved, and the drainage was stopped. Although the incidence of empyema caused by S. milleriis low, it is associated with considerable morbidity and mortality. It is therefore important that patients be diagnosed at an early stage and properly treated with antibiotics and drainage.
